PMID- 33116454 OWN - NLM STAT- MEDLINE DCOM- 20210625 LR - 20210625 IS - 1178-2005 (Electronic) IS - 1176-9106 (Print) IS - 1176-9106 (Linking) VI - 15 DP - 2020 TI - Comorbidity Associations with AATD Among Commercially Insured and Medicare Beneficiaries with COPD in the US. PG - 2389-2397 LID - 10.2147/COPD.S263297 [doi] AB - INTRODUCTION: Alpha-1 antitrypsin deficiency (AATD) is often not identified in patients with chronic obstructive pulmonary disease (COPD) until advanced stages of disease, despite the availability of genetic testing. While clinical practice guidelines provide recommendations on patients who should be tested, more refined algorithms are needed to identify COPD patients who are likely candidates for AATD testing and to prevent delays in diagnosis and treatment. The objective of this study was to identify comorbid associations with AATD among patients diagnosed with COPD in the United States. METHODS: Using data from the 2012-2017 PharMetrics Plus Administrative Claims Database and 2011-2014 Medicare Fee for Service 5% Sample, patients with COPD (ICD-9-CM: 491.xx, 492.xx, or 496, ICD-10-CM J41, J42, J43, J44) and AATD (ICD-9-CM: 273.4, ICD-10-CM: E88.01) were identified. Patient demographic and diagnostic characteristics were assessed. Logistic regression models were developed to identify significant predictors of AATD. RESULTS: A cohort of 344,528 Medicare beneficiaries with COPD (of which 302 (0.09%) also had two diagnoses of AATD) and a cohort of 340,259 commercially insured patients with COPD (of which 1076 (0.3%) also had a diagnosis of AATD) were constructed. Associations with AATD identified in both models included ICD-9-CM and ICD-10-CM codes for chronic pulmonary heart disease, chronic liver disease and cirrhosis, and liver transplant. DISCUSSION: Significant associations with a diagnosis of AATD among patients with COPD were consistently represented in each of the datasets evaluated, which suggests meaningful comorbidity implications in AATD patients. These findings reinforce the need to test individuals with COPD for AATD as early as possible to help reduce the development of associated comorbid conditions. CI - (c) 2020 Sandhaus et al. FAU - Sandhaus, Robert AU - Sandhaus R AUID- ORCID: 0000-0002-7937-2485 AD - Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO, USA. FAU - Strange, Charlie AU - Strange C AUID- ORCID: 0000-0002-8109-8067 AD - Department of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, SC, USA. FAU - Stone, Glenda AU - Stone G AUID- ORCID: 0000-0003-2155-2296 AD - Global Health Economics & Outcomes Research, Grifols Shared Services of North America, Inc, Research Triangle Park, NC, USA. FAU - Runken, M Chris AU - Runken MC AD - Global Health Economics & Outcomes Research, Grifols Shared Services of North America, Inc, Research Triangle Park, NC, USA. FAU - Blanchette, Christopher M AU - Blanchette CM AD - Department of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, USA. FAU - Howden, Reuben AU - Howden R AD - Department of Kinesiology, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, USA. LA - eng PT - Journal Article DEP - 20201005 PL - New Zealand TA - Int J Chron Obstruct Pulmon Dis JT - International journal of chronic obstructive pulmonary disease JID - 101273481 SB - IM MH - Aged MH - Cohort Studies MH - Comorbidity MH - Humans MH - Medicare MH - *Pulmonary Disease, Chronic Obstructive/diagnosis/epidemiology/therapy MH - United States/epidemiology MH - *alpha 1-Antitrypsin Deficiency/epidemiology PMC - PMC7547287 OTO - NOTNLM OT - alpha-1 antitrypsin deficiency OT - chronic obstructive pulmonary disease OT - comorbid OT - genetic COIS- Drs. Stone and Runken, are employees of Grifols Shared Services of North America, a subsidiary of Grifols, Inc. Grifols, Inc., a manufacturer of a marketed therapy for the treatment of AATD, funded this study. Drs. Sandhaus, Strange, and Blanchette have each received consultation fees and/or grant support from Grifols, Inc. in the past. Robert Sandhaus reports Advisory Committee without pay but with reimbursement of travel expenses from Grifols and CSL Behring, outside the submitted work. Charlie Strange reports grants, personal fees, non-financial support from Astra Zeneca, personal fees, non-financial support from Glaxo Smith Kline, grants from MatRx, grants, personal fees, non-financial support from CSL Behring, grants, personal fees, non-financial support from Grifols, grants from Takeda, personal fees from Uptake Medical, grants from Nuvaira, grants from CSA Medical, grants, personal fees, non-financial support from Vertex, outside the submitted work. Glenda Stone reports being an employee of Grifols Shared Services North America, Inc, a manufacturer of a therapy for the treatment of AATD, during the conduct of the study and outside the submitted work. M Chris Runken reports being an employee of Grifols SSNA, during the conduct of the study and outside the submitted work. Christopher M Blanchette reports grants from Grifols, during the conduct of the study. The authors report no other potential conflicts of interest for this work. EDAT- 2020/10/30 06:00 MHDA- 2021/06/29 06:00 PMCR- 2020/10/05 CRDT- 2020/10/29 05:48 PHST- 2020/06/09 00:00 [received] PHST- 2020/09/07 00:00 [accepted] PHST- 2020/10/29 05:48 [entrez] PHST- 2020/10/30 06:00 [pubmed] PHST- 2021/06/29 06:00 [medline] PHST- 2020/10/05 00:00 [pmc-release] AID - 263297 [pii] AID - 10.2147/COPD.S263297 [doi] PST - epublish SO - Int J Chron Obstruct Pulmon Dis. 2020 Oct 5;15:2389-2397. doi: 10.2147/COPD.S263297. eCollection 2020.